Healthcare Provider Details

I. General information

NPI: 1518380112
Provider Name (Legal Business Name): BARBARA SALL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2014
Last Update Date: 02/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 CHURCH ST
DECATUR GA
30030-1587
US

IV. Provider business mailing address

1400 CHURCH ST
DECATUR GA
30030-1587
US

V. Phone/Fax

Practice location:
  • Phone: 404-547-9416
  • Fax:
Mailing address:
  • Phone: 404-547-9416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: